Derek Moore, | |
10 Shurs Ln Ste 301, Philadelphia, PA 19127-2123 | |
(215) 967-1632 | |
Not Available |
Full Name | Derek Moore |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 10 Shurs Ln Ste 301, Philadelphia, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1659931046 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | MT219038 (Pennsylvania) | Primary |
Entity Name | Dedicated Pennsylvania Holding Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1477053569 PECOS PAC ID: 4688935653 Enrollment ID: O20180308000694 |
Mailing Address | Practice Location Address |
---|---|
Derek Moore, 10 Shurs Lane Suite 301, Philadelphia, NJ 19127-2629 Ph: (215) 482-1234 | Derek Moore, 10 Shurs Ln Ste 301, Philadelphia, PA 19127-2123 Ph: (215) 967-1632 |
Srikar Vegesna, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2118 Cottman Ave, Philadelphia, PA 19149 Phone: 215-342-3020 Fax: 215-342-3653 | |
Chelsea Tiffany Salas-tam, Family Medicine Medicare: Medicare Enrolled Practice Location: 833 Chestnut St Ste 301, Philadelphia, PA 19107 Phone: 215-955-7190 | |
Meng-chao Lee, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 7500 Central Ave Ste 104, Philadelphia, PA 19111 Phone: 215-742-0712 Fax: 215-742-5218 | |
Carol Bowes-lawlor, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 33 E Chestnut Hill Ave, Philadelphia, PA 19118 Phone: 215-753-9080 Fax: 215-753-8830 | |
Dr. Seung Hee Hong, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2301 E Allegheny Ave, Suite 150, Philadelphia, PA 19134 Phone: 215-926-3535 Fax: 215-926-3536 | |
Dr. Denise Hamilton Christian, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 251 E Bringhurst St, Philadelphia, PA 19144 Phone: 215-844-1020 Fax: 215-844-8147 | |
Mara Leyzin, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 8025 Castor Ave, Philadelphia, PA 19152 Phone: 215-745-9900 Fax: 215-745-9902 |